Schultz R J, Whitfield G F, LaMura J J, Raciti A, Krishnamurthy S
J Trauma. 1985 Apr;25(4):309-16. doi: 10.1097/00005373-198504000-00005.
Mortality rates for elderly patients with hip fractures have been reported to be as high as 37%. This study evaluated 70 patients of whom 35 were evaluated preoperatively by conventional diagnostic means, and 35 in whom hemodynamic, respiratory, and metabolic status was assessed using a Swan-Ganz balloon-tipped catheter. The derived variables were then calculated by a minicomputer and automatically plotted on a printed graphic display in a bar graph format. This diagnostic modality permitted appreciation of occult physiologic aberrations not detected by conventional methods, enabling correction of these abnormalities preoperatively and postoperatively. The study demonstrated a mortality rate of 2.9% in the monitored group compared to a 29% mortality in the nonmonitored group. The intrinsic assumption that patients should undergo surgery within 24 hours (3) was also modified. The appropriate time for surgery should be accurately determined and chosen on the basis of optimal physiologic balance.
据报道，老年髋部骨折患者的死亡率高达37%。本研究评估了70例患者，其中35例通过传统诊断方法进行术前评估，另外35例使用Swan-Ganz球囊漂浮导管评估血流动力学、呼吸和代谢状态。然后由小型计算机计算得出变量，并自动以柱状图格式绘制在打印的图形显示器上。这种诊断方式能够发现传统方法未检测到的隐匿性生理异常，从而在术前和术后对这些异常进行纠正。研究表明，监测组的死亡率为2.9%，而未监测组的死亡率为29%。患者应在24小时内接受手术这一固有假设（3）也有所改变。应根据最佳生理平衡准确确定并选择合适的手术时间。
